Apparatus and method for cutting tissue

ABSTRACT

A cutting instrument comprising: an outer tube; an inner tube rotatably disposed within the outer tube; the inner tube comprising an opening having a leading edge and a trailing edge; and the outer tube comprising a window having a leading edge and a trailing edge; at least one of the leading edge of the opening, the trailing edge of the opening, the leading edge of the window and the trailing edge of the window comprising a canted edge; and the window of the outer tube being adapted to be completely blocked by the inner tube during a phase of the rotation of the inner tube within the outer tube.

REFERENCE TO PENDING PRIOR PATENT APPLICATION

This patent application claims benefit of pending prior U.S. ProvisionalPatent Application Ser. No. 61/994,293, filed May 16, 2014 by GyrusACMI, Inc. (d.b.a. Olympus Surgical Technologies America) and Joel A.Willhite et al. for APPARATUS AND METHOD FOR CUTTING TISSUE (Attorney'sDocket No. OLYMPUS-2 PROV), which patent application is herebyincorporated herein by reference.

FIELD OF THE INVENTION

This invention relates to surgical apparatus and methods in general, andmore particularly to surgical apparatus and methods for cutting tissue.

BACKGROUND OF THE INVENTION

In many situations, tissue may need to be accessed at a remote surgicalsite, excised from the adjacent anatomy and then the excised tissueremoved from the remote surgical site. By way of example but notlimitation, during arthroscopic surgery, endoscopic surgery, ENTsurgery, etc., relatively small visualization devices (e.g., “scopes”)and relatively small surgical tools (e.g., graspers, cutters,cauterizers, etc.) are generally introduced into a restricted spacewithin the human body (e.g., the interior of a joint, the interior ofthe abdomen, the interior of a nasal passage, etc.) and then used atthat location for a specific surgical procedure (e.g., to trim meniscalcartilage in a joint, to excise a tissue mass in the abdomen, to excisea tissue mass in a nasal passage, etc.). In many such surgeries, fluidis introduced into the surgical site (and thereafter removed from thesurgical site) so as to distend the anatomy for better access and/orvisualization (e.g., so as to distend the knee joint for better accessand/or visualization), and/or to improve visibility (e.g., so as toflush away blood), and/or to remove debris (e.g., so as to removesevered tissue by suction).

One of the surgical tools frequently employed in such surgeries is theso-called “powered shaver”. Powered shavers typically comprise an outertube having a window, and an inner tube rotatably disposed within theouter tube and having an opening, wherein rotation of the inner tubewithin the outer tube causes the opening of the inner tube torepetitively sweep across the window of the outer tube, whereby to shearoff tissue extending into the window of the outer tube. Suction isapplied to the interior of the inner tube so as to remove the tissuesheared off by the powered shaver. See, for example, U.S. Pat. No.4,203,444 (Bonnell et al.) and U.S. Pat. No. 4,867,157 (McGurk-Burlesonet al.).

Unfortunately, current powered shavers tend to suffer from one or moredisadvantages. By way of example but not limitation, current poweredshavers tend to suffer from small window sizes, which is generally theresult of efforts to ensure adequate suction in order to remove sizabledebris through the interior of the inner tube. In addition, currentpowered shavers tend to suffer from inefficient cutting action, which isgenerally the result of the shearing geometries employed. Among otherthings, with current powered shavers, the oscillating motion andlocation of the cutting surfaces tend to “bat” tissue around, in aside-to-side motion. Furthermore, current powered shavers tend to sufferfrom poor suction, which is generally the result of the geometries usedfor the window of the outer tube and the opening in the inner tube.

Thus it would be advantageous to provide a new powered cutter whichimproves upon the deficiencies of the prior art. Among other things, itwould be advantageous to provide a new powered cutter which providesenlarged window sizes, improved cutting action and superior suction.

SUMMARY OF THE INVENTION

The present invention comprises the provision and use of a new poweredcutter which improves upon the deficiencies of the prior art. Amongother things, the new powered cutter provides enlarged window sizes,improved cutting action and superior suction.

In one form of the invention, there is provided a cutting instrumentcomprising:

an outer tube;

an inner tube rotatably disposed within said outer tube;

said inner tube comprising an opening having a leading edge and atrailing edge; and

said outer tube comprising a window having a leading edge and a trailingedge;

at least one of said leading edge of said opening, said trailing edge ofsaid opening, said leading edge of said window and said trailing edge ofsaid window comprising a canted edge; and

said window of said outer tube being adapted to be completely blocked bysaid inner tube during a phase of the rotation of said inner tube withinsaid outer tube.

In another form of the invention, there is provided a cutting instrumentcomprising:

an outer tube;

an inner tube rotatably disposed within said outer tube;

said inner tube comprising an opening having a leading edge and atrailing edge; and

said outer tube comprising a window having a leading edge and a trailingedge;

at least one of said leading edge of said opening and said trailing edgeof said opening comprising a canted edge, and at least one of saidleading edge of said window and said trailing edge of said windowcomprising a canted edge; and

wherein said at least one canted edge of said opening and said at leastone canted edge of said window are canted in the same direction of turn.

In another form of the invention, there is provided a method for cuttingan object, the method comprising:

providing a cutting instrument comprising:

-   -   an outer tube;    -   an inner tube rotatably disposed within said outer tube;    -   said inner tube comprising an opening having a leading edge and        a trailing edge; and    -   said outer tube comprising a window having a leading edge and a        trailing edge;    -   at least one of said leading edge of said opening, said trailing        edge of said opening, said leading edge of said window and said        trailing edge of said window comprising a canted edge; and    -   said window of said outer tube being adapted to be completely        blocked by said inner tube during a phase of the rotation of        said inner tube within said outer tube;

positioning the object in said window; and

rotating said inner tube within said outer tube.

In another form of the invention, there is provided a method for cuttingan object, the method comprising:

providing cutting instrument comprising:

-   -   an outer tube;    -   an inner tube rotatably disposed within said outer tube;    -   said inner tube comprising an opening having a leading edge and        a trailing edge; and    -   said outer tube comprising a window having a leading edge and a        trailing edge;    -   at least one of said leading edge of said opening and said        trailing edge of said opening comprising a canted edge, and at        least one of said leading edge of said window and said trailing        edge of said window comprising a canted edge; and    -   wherein said at least one canted edge of said opening and said        at least one canted edge of said window are canted in the same        direction of turn;

positioning the object in said window; and

rotating said inner tube within said outer tube.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other objects and features of the present invention will bemore fully disclosed or rendered obvious by the following detaileddescription of the preferred embodiments of the invention, which is tobe considered together with the accompanying drawings wherein likenumbers refer to like parts and further wherein:

FIG. 1 is a schematic view showing a novel powered cutter formed inaccordance with the present invention;

FIGS. 2-5 are schematic views showing the blade assembly of the poweredcutter shown in FIG. 1;

FIG. 6 is a schematic view showing the outer tube of the blade assemblyshown in FIGS. 2-5;

FIGS. 7-9 are schematic views showing the inner tube of the bladeassembly shown in FIGS. 2-5;

FIGS. 10A-10C are schematic views showing the blade assembly indifferent states of operation;

FIGS. 11-14 are schematic views showing alternative constructions forthe outer tube of the blade assembly; and

FIG. 15 is a schematic view showing an alternative construction for theinner tube of the blade assembly.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The present invention comprises the provision and use of a new poweredcutter which improves upon the deficiencies of the prior art. Amongother things, this new powered cutter provides enlarged window sizes,improved cutting action and superior suction.

More particularly, and looking now at FIG. 1, there is shown a novelpowered cutter 5 formed in accordance with the present invention. Novelpowered cutter 5 generally comprises a blade assembly 10 and a handleassembly 15. As will hereinafter be discussed in further detail, bladeassembly 10 is intended to be mated to handle assembly 15 (or anotherhandle assembly) at the time of use, and detached from handle assembly15 (or another handle assembly) after use (e.g., for cleaning andsterilization, repair or replacement, etc.). Alternatively, bladeassembly 10 may be mated to handle assembly 15 (or another handleassembly) at the time of manufacture, e.g., such as in the case of aone-piece disposable system.

Blade assembly 10 is shown in greater detail in FIGS. 1-5. Bladeassembly 10 generally comprises an outer tube 20 and inner tube 25rotatably disposed within outer tube 20.

Outer tube 20 is shown in greater detail in FIGS. 1-6. Outer tube 20generally comprises a distal end 35, a proximal end 40, and a lumen 45extending from distal end 35 to proximal end 40. In one preferred formthe present invention, outer tube 20 preferably comprises a closeddistal end 48.

Outer tube 20 comprises a window 50 comprising a leading edge 55 and atrailing edge 60. In one preferred form of the invention, leading edge55 and trailing edge 60 are canted relative to the longitudinal axis 61of outer tube 20. In one preferred form of the invention, leading edge55 and trailing edge 60 have a helical configuration (which may be ofconstant pitch or non-constant pitch). In another preferred form of theinvention, leading edge 55 and trailing edge 60 have a configurationwhich is a segment of an ellipse. In one preferred form of the presentinvention, outer tube 20 also comprises a first edge 65 connectingleading edge 55 to trailing edge 60, and a second edge 70 connectingleading edge 55 to trailing edge 60. In one preferred form of theinvention, leading edge 55, trailing edge 60, first edge 65 and secondedge 70 form a prismatic section of a parallelogram.

Inner tube 25 is shown in greater detail in FIGS. 1-5 and 7-9. Innertube 25 generally comprises a distal end 75, a proximal end 80, and alumen 83 extending from distal end 75 to proximal end 80. In onepreferred form of the present invention, inner tube 25 preferablycomprises a closed distal end 84.

Inner tube 25 comprises an opening 85 comprising a leading edge 90 and atrailing edge 95. In one preferred form of the invention, leading edge90 and trailing edge 95 are canted relative to the longitudinal axis 96of inner tube 25. In one preferred form of the invention, leading edge90 and trailing edge 95 have a helical configuration (which may be ofconstant pitch or non-constant pitch). In another preferred form of theinvention, leading edge 90 and trailing edge 95 have a configurationwhich is a segment of an ellipse.

It should be appreciated that leading edge 90 of inner tube 25 extendsat an angle to trailing edge 60 of outer tube 20, and/or trailing edge95 of inner tube 25 extends at an angle to leading edge 55 of outer tube20, so as to create a shearing action between such surfaces (i.e.,edges) when inner tube 25 is rotated relative to outer tube 20, as willhereinafter be discussed.

Inner tube 25 is rotatably disposed within outer tube 20 such thatrotation of inner tube 25 within outer tube 20 causes opening 85 ofinner tube 25 to repetitively sweep across window 50 of outer tube 20,whereby to shear off tissue extending into window 50 of outer tube 20.More particularly, in accordance with the present invention, as innertube 25 is rotated within outer tube 20, leading edge 90 of inner tube25 is swept across trailing edge 60 of outer tube 20 or, depending onthe direction of rotation of inner tube 25 relative to outer tube 20,trailing edge 95 of inner tube 25 is swept across leading edge 55 ofouter tube 20, so as to create a shearing action at the interface ofleading edge 90 of inner tube 25 and trailing edge 60 of outer tube 20,or at the interface of trailing edge 95 of inner tube 25 and leadingedge 55 of outer tube 20. This shearing action serves to cut away tissueextending into window 50 of outer tube 20. It should be appreciated thatthis shearing action is superior to the cutting action of conventionalpowered cutters due to the moving point contact of the shearing(“scissoring”) surfaces (i.e., edges). In addition, this shearing actionis superior to the cutting action of conventional powered cutters,inasmuch as the cutting forces of novel powered cutter 5 are generallydirected proximally or distally, rather than laterally (as is the casewhere the side edges of windows are used for cutting). Directing thecutting forces proximally or distally, rather than laterally, can helpthe surgeon keep the powered cutter in the desired position and alsohelp keep tissue from being “batted” around, in a side-to-side motion,during cutting. Suction applied to lumen 83 of inner tube 25 removes theexcised tissue from blade assembly 10.

If desired, space can be provided between inner tube 25 and outer tube20 so as to allow irrigation to be supplied to the surgical site.

In one preferred form of the invention, inner tube 25 is configured tocompletely block window 50 of outer tube 20 during a phase of therotation of inner tube 25 within outer tube 20. As a result, largerwindow sizes can be used while still providing superior suction for theblade assembly.

In one preferred form of the invention, and looking now at FIGS. 10A,10B and 10C, blade assembly 10 can be considered to assume threedifferent “states” as inner tube 25 rotates within outer tube 20, i.e.,a “window fully open” state (FIG. 10A) where suction is used tofacilitate tissue engagement, a “resecting” state (FIG. 10B) where thesurfaces (i.e., edges) of inner tube 25 and outer tube 20 cooperate toprovide a scissoring action so as to cut tissue extending into window 50of outer tube 20, and a “window fully closed” state (FIG. 10C) whereinner tube 25 substantially completely closes off window 50 of outertube 20, thereby allowing for maximum inner lumen suction to rid thecutting area of tissue and fluid.

As shown in FIG. 1, blade assembly 10 is intended to be mated to handleassembly 15 (or another handle assembly) at the time of use, anddetached from handle assembly 15 (or another handle assembly) after use(e.g., for cleaning and sterilization, repair or replacement, etc.).Alternatively, blade assembly 10 may be mated to handle assembly 15 (oranother handle assembly) at the time of manufacture, e.g., such as inthe case of a one-piece disposable system. Handle assembly 15 isprovided with a housing 100 for securely mounting the distal end 40 ofouter tube 20, and means for coupling a drive shaft 105 to inner tube25, e.g., a connector 115 which is secured to drive shaft 105 and innertube 25. Preferably connector 115 is provided with appropriate ports sothat the interior of inner tube 25 is in fluid communication with asuction port 120, whereby to provide suction to blade assembly 10.

It should be appreciated that handle assembly 15 shown in FIG. 1 isprovided by way of example but not limitation, and other handleassemblies may be used in conjunction with blade assembly 10.

FIGS. 11-14 show alternative configurations for outer tube 20 and itswindow 50.

More particularly, in FIG. 11, window 50 is constructed so that itsleading edge 55 extends perpendicular to the longitudinal axis of outertube 25 and its trailing edge 60 is canted relative to the longitudinalaxis 61 of outer tube 25, with first edge 65 and second edge 70extending between leading edge 55 and trailing edge 60.

In FIG. 12, window 50 is constructed so that its leading edge 55 and itsfirst edge 65 and second edge 70 combine to form an arcuate surface(i.e., edge), and its trailing edge 60 is canted relative to thelongitudinal axis 61 of outer tube 25.

In FIG. 13, window 50 is constructed so that its leading edge 55 and itsfirst edge 65 combine to form an arcuate surface (i.e., edge), itstrailing edge 60 is canted relative to the longitudinal axis 61 of outertube 25, and its second edge 70 extends between leading edge 55 andtrailing edge 60.

In FIG. 14, window 50 is constructed so that its leading edge 55 and itstrailing edge 60 are canted in opposite directions relative to thelongitudinal axis of outer tube 25, with first edge 65 and second edge70 extending between leading edge 55 and trailing edge 60.

FIG. 15 shows an alternative configuration for inner tube 25 and itsopening 85, wherein leading edge 90 extends perpendicular to thelongitudinal axis of inner tube 25 and trailing edge 95 has a helicalconfiguration.

The powered shaver of the present invention improves upon thedeficiencies of the prior art. Among other things, the new poweredcutter provides enlarged window sizes, improved cutting action andsuperior suction.

Modifications of the Preferred Embodiments

It should be understood that many additional changes in the details,materials, steps and arrangements of parts, which have been hereindescribed and illustrated in order to explain the nature of the presentinvention, may be made by those skilled in the art while still remainingwithin the principles and scope of the invention.

1.-20. (canceled)
 21. A cutting instrument comprising: an outer tube; aninner tube rotatably disposed within said outer tube; said outer tubecomprising a window having a leading edge and a trailing edge; andwherein said window of said outer tube is progressively increasinglyblocked, from said leading edge of said window to said trailing edge ofsaid window, during successive phases of rotation of said inner tubewithin said outer tube, and completely blocked by said inner tube duringa phase of the rotation of said inner tube within said outer tube.
 22. Acutting instrument according to claim 21 wherein said inner tubecomprises an opening having a leading edge and a trailing edge.
 23. Acutting instrument according to claim 22 wherein at least one of saidleading edge of said opening, said trailing edge of said opening, saidleading edge of said window and said trailing edge of said windowcomprises a canted edge.
 24. A cutting instrument according to claim 23wherein said canted edge comprises a helix of constant pitch.
 25. Acutting instrument according to claim 23 wherein said canted edgecomprises a segment of an ellipse.
 26. A cutting instrument according toclaim 21 wherein, during rotation of said inner tube relative to saidouter tube, a scissoring effect is created at one of said leading edgeof said window and said trailing edge of said window.
 27. A cuttinginstrument according to claim 22 wherein at least one of said leadingedge of said opening and said trailing edge of said opening comprises ahelix.
 28. A cutting instrument according to claim 21 wherein at leastone of said leading edge of said window and said trailing edge of saidwindow comprises a helix.
 29. A cutting instrument according to claim 27wherein at least one of said leading edge of said opening and saidtrailing edge of said opening comprises a different pitch than at leastone of said leading edge of said window and said trailing edge of saidwindow.
 30. A cutting instrument according to claim 23 wherein at leastone edge of said opening is canted, at least one edge of said window iscanted, and said at least one canted edge of said opening and said atleast one canted edge of said window are canted in the same direction ofturn.
 31. A cutting instrument according to claim 22 wherein at leastone of said leading edge of said opening and said trailing edge of saidopening comprises a canted edge, and at least one of said leading edgeof said window and said trailing edge of said window comprises a cantededge; and wherein said at least one canted edge of said opening and saidat least one canted edge of said window are canted in the same directionof turn.
 32. A cutting instrument according to claim 29 wherein said atleast one canted edge of said opening comprises a helix of constantpitch, and further wherein said at least one canted edge of said windowcomprises a helix of constant pitch.
 33. A cutting instrument accordingto claim 29 wherein said at least one canted edge of said openingcomprises a segment of an ellipse, and further wherein said at least onecanted edge of said window comprises a segment of an ellipse.
 34. Acutting instrument according to claim 29 wherein, during rotation ofsaid inner tube relative to said outer tube, a scissoring effect iscreated at one of said leading edge of said opening and said trailingedge of said opening.
 35. A cutting instrument according to claim 29wherein, during rotation of said inner tube relative to said outer tube,a scissoring effect is created at one of said leading edge of saidwindow and said trailing edge of said window.
 36. A cutting instrumentaccording to claim 29 wherein at least one of said leading edge of saidopening and said trailing edge of said opening comprises a helix.
 37. Acutting instrument according to claim 29 wherein at least one of saidleading edge of said window and said trailing edge of said windowcomprises a helix.
 38. A cutting instrument according to claim 33wherein at least one of said leading edge of said opening and saidtrailing edge of said opening comprises a different pitch than at leastone of said leading edge of said window and said trailing edge of saidwindow.
 39. A method for cutting an object, the method comprising:providing a cutting instrument comprising: an outer tube; an inner tuberotatably disposed within said outer tube; said outer tube comprising awindow having a leading edge and a trailing edge; wherein said window ofsaid outer tube is progressively increasingly blocked, from said leadingedge of said window to said trailing edge of said window, duringsuccessive phases of rotation of said inner tube within said outer tube,and completely blocked by said inner tube during a phase of the rotationof said inner tube within said outer tube; positioning the object insaid window; and rotating said inner tube within said outer tube.
 40. Acutting instrument comprising: an outer tube; an inner tube rotatablydisposed within said outer tube; said inner tube comprising an openinghaving a leading edge and a trailing edge; and said outer tubecomprising a window having a leading edge and a trailing edge; at leastone of said leading edge of said opening, said trailing edge of saidopening, said leading edge of said window and said trailing edge of saidwindow comprising a canted edge; and wherein said window of said outertube is progressively increasingly blocked, from said leading edge ofsaid window to said trailing edge of said window, during successivephases of rotation of said inner tube within said outer tube, andcompletely blocked by said inner tube during a phase of the rotation ofsaid inner tube within said outer tube.